Coronary Heart Disease And Mental Health

Mental health refers to your emotional, psychological and social well-being. It is as crucial as your physical health. Yet, some people often overlook the importance of maintaining good mental health. In fact, the negligence of mental health can lead to serious health problems such as coronary heart disease. 

Surprisingly, several studies have revealed the links between coronary heart disease and mental illness.¹ Some suggested that both might cause one another.¹ Thus, this article reviews the relationship between coronary heart disease and mental health. 

What is coronary heart disease?

Coronary heart disease (CHD) is a common illness around the world that took away roughly 7.4 million precious lives per year. ^{1, 2} CHD is also known as ischemic heart disease or coronary heart disease. ¹ So, how does CHD occur? CHD occurs due to the accumulation of fatty deposits, called plaque, in your coronary artery, which blocks your heart’s blood supply. Just imagine an artery as a garden hose. Too much dirt or sediment in the hose will interrupt the water supply, making it hard for it to flow out.² As a result, your heart and the surrounding tissues will receive an inadequate supply of blood, which can lead to a myocardial infarction (MI, a.k.a. Heart Attack). Poor lifestyles, smoking, older age, stress and diabetes are several factors that can increase the risk of developing CHD. ¹

How does coronary heart disease affect mental health?

Mental disorders can be a heart disease risk factor

Researchers demonstrated that destructive behaviour is involved in the relationship between mental disorders and coronary heart disease. Depression, schizophrenia and bipolar disorder , as well as other mental disorders (anxiety disorders), might be associated with several behaviours that eventually lead to heart disease. ¹ People with mental illnesses tend to display unhealthy habits (high fat diet, smoking, alcohol or other substance use, lack of physical exercise), which can increase the risk of CHD.¹ Furthermore, some of these patients might have difficulty following their rehabilitation programs and possibly struggle to take their prescribed medicine (cardioprotective or other medications) correctly.¹ As a result, it can lead to an unending cycle of unhealthy habits which might worsen or increase the risk of CHD. ¹

Other than that, patients with mental disorders such as major depressive disorder (MDD) and anxiety disorders usually have high levels of catecholamines. ¹ They will cause increases in heart rate and blood pressure while decreasing coronary blood flow. Therefore, the processes may contribute to the high risk of CHD among people with these disorders. ¹ 

Some medications for a mental disorder, such as antidepressants, may increase the risk of CHD, although the findings vary. ^1,3 One example is a tricyclic antidepressant. It can cause orthostatic hypotension, may possibly slow cardiac conduction in some cases, and can lead to an increased heart rate. SSRI’s, another type of antidepressant, might be a safer option and are known to have better cardiovascular safety. ³

Mental health post heart disease episodes 

Heart disease also can increase the risk of developing a mental disorder. According to experts, PTSD symptoms occur in 10% to 25% of patients with heart disease. Sudden cardiac episodes accompanied by invasive treatments such as coronary surgery can be scary and potentially traumatic.⁴ As a result, it can lead to PTSD. However, not all heart disease patients will develop PTSD as some may experience distress that eventually diminishes. ⁴

If you or someone close to you is struggling with mental health

Sometimes, you feel a little low, and nothing is wrong or out-of-the-ordinary about that. However, more serious mental health issues need to be spotted and acted upon promptly. If you are worried about your own health or the health of another, there are numerous organisations to help and support you.  These include (in the UK) the NHS and the Samaritans, plus there may be local organisations as well.  Internationally, other organations my be able to help, just Google “Mental Health Support”.  A good first port of call is always your GP (family doctor).

Another way to help you deal with your mental health issues might be journaling. Have you tried journaling before? Although the finding regarding the efficacy of journaling in managing mental health issues is inconclusive, it is worth the try. You can channel all your feelings in a journal instead of bottling up your emotions. ⁵ It is also okay to ask for help from your friends. 

If someone close to you is struggling, you can help by showing how much you care about them. Lend your shoulders and ears to listen thoroughly. However, do not pressure them to tell you their concern. They may not want to open up to you at first, they may tell you things are fine, so be patient and above all, be kind. Here are other things you can try to help others with mental health issues. 

When to contact a doctor

Seek medical attention immediately if you have these symptoms:²

1. Chest pain
2. Shortness of breath
3. Pain throughout the body, especially in the neck, jaw, left arm and back.

In addition, always seek professional help and support if you or someone close to you is suffering with a mental health issue (see above).

Summary

Several studies have established the relationship between mental health and CHD. Mental disorders can lead to CHD and vice versa. However, it is a complicated relationship that can be affected by many factors. Thus, some studies demonstrated different findings. Nevertheless, mental health is crucial. Look after yourself and maybe try journaling once in a while. Then, you can take care of your loved ones as well.